Nurses' self‐reported medication competence in relation to their pharmacovigilant activities in clinical practice

Johansson-Pajala, Rose-Marie; Martin, Lene; Fastbom, Johan; Blomgren, Kerstin Jorsäter

doi:10.1111/jep.12263

Cited by 17 publications

(17 citation statements)

References 27 publications

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“…However, it is not possible to investigate whether this played a role in the results of the present study. Research indicates that nurses’ participation in courses seeking to improve medication competencies improve their skills in pharmacovigilance along with their self‐perceived ability to undertake pharmacovigilant activities . Future research should investigate the type of pharmacological training nurses should receive during their education and the skills and competencies that can be reasonably expected from a qualified nurse to improve medication safety for psychiatric patients.…”

Section: Discussionmentioning

confidence: 99%

Improving Medication Safety in Psychiatry – A Controlled Intervention Study of Nurse Involvement in Avoidance of Potentially Inappropriate Prescriptions

Soerensen

Lisby

Nielsen

et al. 2018

Basic Clin Pharma Tox

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The aim of this controlled, before-and-after study in the Department of Psychiatry in a university hospital in Denmark was to examine the potential effects and characteristics of nurses reviewing psychiatric patients' medication records to identify potentially inappropriate prescriptions (PIPs). The control group and the intervention group each consisted of two bed units chosen based on patients' diagnoses and age categories. There were 396 patients (age ≥18 years) included in the study. Senior clinical pharmacology physicians performed medication reviews for all patients in the study; these medication reviews were considered gold standard. The intervention group: nurses were given a pharmacology course after which the nurses reviewed medication lists and subsequently conferred any identified PIPs with physicians. The control group: medication was reviewed as usual and nurses did not participate. Primary outcome measure was the potential difference in PIPs between the control group and the intervention group, analysed in two ways: (i) difference in mean number of PIPs and (ii) difference in number of patients exposed to ≥1 PIP, using regression analysis with an approximated difference-in-difference (DID) approach. Secondary outcome measure was characteristics of PIPs where physicians responded to nurse-identified PIPs. The DID between intervention group and control group for mean number of PIPs per patient was -0.23 (-1.07 to 0.60), and for number of patients receiving ≥1 PIP, the odds ratio was 0.61 (0.25 to 1.46). Physicians changed most prescriptions in the category interaction between drugs. Nurses could not significantly reduce the prevalence of PIPs for psychiatric patients.

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Section: Discussionmentioning

confidence: 99%

Improving Medication Safety in Psychiatry – A Controlled Intervention Study of Nurse Involvement in Avoidance of Potentially Inappropriate Prescriptions

Soerensen

Lisby

Nielsen

et al. 2018

Basic Clin Pharma Tox

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“…detecting, assessing, and reporting drug-related problems, have been found to be low, in spite of a high level of self-rated competence within the area. [ 16 ]…”

Section: Introductionmentioning

confidence: 99%

Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management

Johansson-Pajala

Blomgren

Bastholm‐Rahmner

et al. 2016

Scandinavian Journal of Primary Health Care

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ObjectiveTo explore registered nurses’ experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities.DesignA qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis.SettingFive focus groups in five different long-term care settings in two regions in Sweden.SubjectA total of 21 registered nurses (RNs), four men and 17 women, aged 27–65 years, with 4–34 years of nursing experience.ResultsThe findings reveal that RNs in municipal long-term care settings can be regarded as “vigilant intermediaries” in the patients’ drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking.ConclusionThe RNs play a central but also complex role as “vigilant intermediaries” in the medication monitoring process, including the issue of responsibility. Improving RNs’ possibility to monitor their patients’ drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs’ pharmacovigilant activities. Key pointsThis study contributes to the understanding of registered nurses’ (RNs’) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems). RNs can be considered to be “vigilant intermediaries” in elderly patients’ drug treatments, working at a distance from staff, physicians, and patients.RNs occasionally take on responsibilities that exceed their formal competence, with the patients’ best interests in mind.In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs’ pharmacovigilant activities.

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“…A recent study showed that after attending dedicated university courses, nurses improved their competence but did not increase their pharmacovigilance activities (Johansson‐Pajala et al . ). Any intervention to promote ADR reporting should be focused a priori on an assessment of the organisational context and all determinants of the intention to report ADRs.…”

Section: Discussionmentioning

confidence: 97%

Testing an explanatory model of nurses’ intention to report adverse drug reactions in hospital settings

et al. 2017

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Nurses' self‐reported medication competence in relation to their pharmacovigilant activities in clinical practice

Abstract: Dedicated university courses improved nurses' self-reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.

Cited by 17 publications

References 27 publications

Improving Medication Safety in Psychiatry – A Controlled Intervention Study of Nurse Involvement in Avoidance of Potentially Inappropriate Prescriptions

Improving Medication Safety in Psychiatry – A Controlled Intervention Study of Nurse Involvement in Avoidance of Potentially Inappropriate Prescriptions

Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management

Testing an explanatory model of nurses’ intention to report adverse drug reactions in hospital settings

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